Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 0810005342 | VA |
NPI | 1083161368 |
---|---|
Provider Name | Dr. Nancy Watt Marin |
First Address | Arlington, VA 22207-1823 |
Second Address | Arlington, VA 22207-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2016 |
Last Update Date | 05/09/2016 |